Effects of Early and Systematic Integration of Specialist
Palliative Care in Patients with Advanced Cancer: Randomized
Controlled Trial PALINT

J 2020

Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT

SLÁMA, Ondřej, Lukas POCHOP, Jiří ŠEDO, Jan ŠVANCARA, Petra ŠEDOVÁ et. al.

Základní údaje

Originální název

Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT

Autoři

SLÁMA, Ondřej (203 Česká republika, garant, domácí), Lukas POCHOP (203 Česká republika), Jiří ŠEDO (203 Česká republika), Jan ŠVANCARA (203 Česká republika, domácí), Petra ŠEDOVÁ (203 Česká republika), Lucie SVETLAKOVA (203 Česká republika), Regina DEMLOVÁ (203 Česká republika, domácí) a Rostislav VYZULA (203 Česká republika, domácí)

Vydání

JOURNAL OF PALLIATIVE MEDICINE, NEW ROCHELLE, MARY ANN LIEBERT, INC, 2020, 1096-6218

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.947

Kód RIV

RIV/00216224:14110/20:00116202

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1089/jpm.2019.0697

UT WoS

000532181600001

Klíčová slova anglicky

advanced cancer; early palliative care; hospital-specific palliative care issues; multidisciplinary care; specialist palliative care

Štítky

14110516, 14110811, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 13. 5. 2021 07:48, Mgr. Tereza Miškechová

Anotace

V originále

Background: A broad consensus on the optimal structure, intensity, and timing of early specialist palliative care (SPC) intervention is lacking. Objective: To evaluate the benefit of an early and systematic palliative intervention alongside standard oncology care compared with standard oncology care alone in patients with advanced solid tumors. Design: PALINT, a single-center RCT, conducted at the Masaryk Memorial Cancer Institute, the largest comprehensive cancer center in the Czech Republic (CR). Setting/Subjects/Measurements: Patients with newly diagnosed advanced cancer within six weeks from the start of the palliative systemic therapy were randomly assigned to the integration of SPC (intervention; a consultation with a PC physician every six to eight weeks) or to the standard oncology care (control). The primary endpoint was the quality of life (QOL) assessed by EORTC QLQ C30 and Hospital Anxiety and Depression Scale (HADS) at three and six months. Results: From 2015 to 2017, a total of 126 patients were randomly assigned to intervention (60) or to control (66) arm. At baseline, at three and six months, the global QOL scores (mean, 95% CI) in the intervention and control arm were 58.6 (53.9-63.3), 61.9 (56.4-67.4) and 66.7 (60.2-73.2) versus 54.2 (49.4-58.9), 59.0 (53.7-64.3), and 62.8 (56.7-68.9), respectively. The prevalence of anxiety (HADS-A; value >7) was 36.7%, 27.5%, and 18.9% versus 34.8%, 23.5%, and 16.3% and the prevalence of depression (HADS-D; value >7) was 28.3%, 25.4%, and 29.7% versus 28.8%, 29.4%, and 27.9%, respectively. There was no significant difference between the two arms. The overall survival was similar in both arms (347 vs. 310 days; p = 0.203). Conclusions: A model of early integration of SPC consisting of a consultation with a PC physician alone every six to eight weeks did not increase the QOL of patients with advanced cancer compared with routine oncology care in a center with widely available supportive services. These negative results underline the importance of the multidisciplinary patient centered approach in the early SPC.

Návaznosti

LM2018128, projekt VaV

Název: Český národní uzel Evropské sítě infrastruktur klinického výzkumu (Akronym: CZECRIN)

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Český národní uzel Evropské sítě infrastruktur klinického výzkumu (CZECRIN)

Citovat

SLÁMA, Ondřej, Lukas POCHOP, Jiří ŠEDO, Jan ŠVANCARA, Petra ŠEDOVÁ, Lucie SVETLAKOVA, Regina DEMLOVÁ a Rostislav VYZULA. Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT. JOURNAL OF PALLIATIVE MEDICINE. NEW ROCHELLE: MARY ANN LIEBERT, INC, 2020, roč. 23, č. 12, s. 1586-1593. ISSN 1096-6218. Dostupné z: https://dx.doi.org/10.1089/jpm.2019.0697.

@article{1674064,
   author = {Sláma, Ondřej and Pochop, Lukas and Šedo, Jiří and Švancara, Jan and Šedová, Petra and Svetlakova, Lucie and Demlová, Regina and Vyzula, Rostislav},
   article_location = {NEW ROCHELLE},
   article_number = {12},
   doi = {http://dx.doi.org/10.1089/jpm.2019.0697},
   keywords = {advanced cancer; early palliative care; hospital-specific palliative care issues; multidisciplinary care; specialist palliative care},
   language = {eng},
   issn = {1096-6218},
   journal = {JOURNAL OF PALLIATIVE MEDICINE},
   title = {Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT},
   url = {https://www.liebertpub.com/doi/10.1089/jpm.2019.0697},
   volume = {23},
   year = {2020}
}

TY  - JOUR
ID  - 1674064
AU  - Sláma, Ondřej - Pochop, Lukas - Šedo, Jiří - Švancara, Jan - Šedová, Petra - Svetlakova, Lucie - Demlová, Regina - Vyzula, Rostislav
PY  - 2020
TI  - Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT
JF  - JOURNAL OF PALLIATIVE MEDICINE
VL  - 23
IS  - 12
SP  - 1586-1593
EP  - 1586-1593
PB  - MARY ANN LIEBERT, INC
SN  - 10966218
KW  - advanced cancer
KW  - early palliative care
KW  - hospital-specific palliative care issues
KW  - multidisciplinary care
KW  - specialist palliative care
UR  - https://www.liebertpub.com/doi/10.1089/jpm.2019.0697
L2  - https://www.liebertpub.com/doi/10.1089/jpm.2019.0697
N2  - Background: A broad consensus on the optimal structure, intensity, and timing of early specialist palliative care (SPC) intervention is lacking. Objective: To evaluate the benefit of an early and systematic palliative intervention alongside standard oncology care compared with standard oncology care alone in patients with advanced solid tumors. Design: PALINT, a single-center RCT, conducted at the Masaryk Memorial Cancer Institute, the largest comprehensive cancer center in the Czech Republic (CR). Setting/Subjects/Measurements: Patients with newly diagnosed advanced cancer within six weeks from the start of the palliative systemic therapy were randomly assigned to the integration of SPC (intervention; a consultation with a PC physician every six to eight weeks) or to the standard oncology care (control). The primary endpoint was the quality of life (QOL) assessed by EORTC QLQ C30 and Hospital Anxiety and Depression Scale (HADS) at three and six months. Results: From 2015 to 2017, a total of 126 patients were randomly assigned to intervention (60) or to control (66) arm. At baseline, at three and six months, the global QOL scores (mean, 95% CI) in the intervention and control arm were 58.6 (53.9-63.3), 61.9 (56.4-67.4) and 66.7 (60.2-73.2) versus 54.2 (49.4-58.9), 59.0 (53.7-64.3), and 62.8 (56.7-68.9), respectively. The prevalence of anxiety (HADS-A; value >7) was 36.7%, 27.5%, and 18.9% versus 34.8%, 23.5%, and 16.3% and the prevalence of depression (HADS-D; value >7) was 28.3%, 25.4%, and 29.7% versus 28.8%, 29.4%, and 27.9%, respectively. There was no significant difference between the two arms. The overall survival was similar in both arms (347 vs. 310 days; p = 0.203). Conclusions: A model of early integration of SPC consisting of a consultation with a PC physician alone every six to eight weeks did not increase the QOL of patients with advanced cancer compared with routine oncology care in a center with widely available supportive services. These negative results underline the importance of the multidisciplinary patient centered approach in the early SPC.
ER  -

SLÁMA, Ondřej, Lukas POCHOP, Jiří ŠEDO, Jan ŠVANCARA, Petra ŠEDOVÁ, Lucie SVETLAKOVA, Regina DEMLOVÁ a Rostislav VYZULA. Effects of Early and Systematic Integration of Specialist Palliative Care in Patients with Advanced Cancer: Randomized Controlled Trial PALINT. \textit{JOURNAL OF PALLIATIVE MEDICINE}. NEW ROCHELLE: MARY ANN LIEBERT, INC, 2020, roč.~23, č.~12, s.~1586-1593. ISSN~1096-6218. Dostupné z: https://dx.doi.org/10.1089/jpm.2019.0697.

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